Today (28 January) Donald Trump signed an executive order titled ‘Protecting Children From Chemical and Surgical Mutilation’.
The order bans so-called ‘chemical and surgical mutilation’ for under-19s: a term which is used throughout the document to describe gender-affirming care by way of hormone therapy (such as puberty blockers and ‘cross-sex hormones’) and surgeries (such as top surgery or bottom surgery).
Specifically, it states: “it is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called “transition” of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”
The order follows a suite of state-level bans on gender-affirming care for minors, with 26 states having passed laws restricting its provision by December 2024. Indeed, gender-affirming care for youth is a popular culture wars topic and the wording of Trump’s order plays into this – making reference to “countless children” accessing this care and referring to the care itself as “destructive and life-altering procedures” and “irreversible medical interventions”.
However, this is far from the case. Gender-affirming care has been shown to have positive outcomes for trans patients: hormone therapy leading to better depression outcomes and surgical interventions leading to reduced suicidality and better quality of life. Detransition rates are also low, with the highest estimate sitting at 8%.
The insinuation that gender-affirming care for minors is widespread is also fundamentally untrue.
On 6 January, JAMA Pediatrics published a peer-reviewed research letter which showed that the percentage of US teens receiving gender-affirming care via private insurance was very low, sitting at around 0.1%. For reference, the research used a data set of private insurance claims from 2018-2022 that included more than 5 million US teenagers.
“The total number of youth who had any diagnosis of gender dysphoria was less than 18,000,” Langdon Hughes, one of the letter’s co-authors, explained to NPR. “Among those folks, there were less than 1,000 [youth] that accessed puberty blockers and less than 2,000 that ever had access to hormones.”
Another research letter published by JAMA Network Open on 27 June 2024 demonstrated that gender-affirming surgeries are rarely performed on trans youth. It also found that cis minors and adults had higher utilisation of similar gender-affirming surgeries than their trans counterparts.
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